Cai PC, Luo C, Liu JP. Individualized enhanced recovery after pancreaticoduodenectomy surgical pathways management: Key variables and optimization strategies. World J Gastrointest Surg 2026; 18(7): 120727 [DOI: 10.4240/wjgs.v18.i7.120727]
Corresponding Author of This Article
Jian-Ping Liu, Associate Chief Physician, Department of General Surgery, The First People’s Hospital of Shuangliu District, No. 120 North City Street, Dongsheng Subdistrict, Shuangliu District, Chengdu 610200, Sichuan Province, China. liujianping2026@126.com
Research Domain of This Article
Gastroenterology & Hepatology
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review-article
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Cai PC, Luo C, Liu JP. Individualized enhanced recovery after pancreaticoduodenectomy surgical pathways management: Key variables and optimization strategies. World J Gastrointest Surg 2026; 18(7): 120727 [DOI: 10.4240/wjgs.v18.i7.120727]
World J Gastrointest Surg. Jul 27, 2026; 18(7): 120727 Published online Jul 27, 2026. doi: 10.4240/wjgs.v18.i7.120727
Individualized enhanced recovery after pancreaticoduodenectomy surgical pathways management: Key variables and optimization strategies
Peng-Cheng Cai, Chao Luo, Jian-Ping Liu
Peng-Cheng Cai, Chao Luo, Jian-Ping Liu, Department of General Surgery, The First People’s Hospital of Shuangliu District, Chengdu 610200, Sichuan Province, China
Author contributions: Cai PC contributed to conceptualization, literature search, data curation, original draft writing and visualization; Luo C participated in literature review, data analysis, manuscript revision and validation; Liu JP was responsible for conceptualization, supervision, project administration, manuscript revision, funding acquisition and correspondence. All authors have read and approved the final manuscript.
AI contribution statement: During the writing process of this article, the author only used AI tools (DeepSeek) to polish the language and text, optimize expression fluency. AI tools did not participate in any analysis of research content, derivation and formation of research conclusions. All output content generated by AI has been strictly reviewed, modified and finally confirmed by all authors, who bear full responsibility for the entire content of the article.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Jian-Ping Liu, Associate Chief Physician, Department of General Surgery, The First People’s Hospital of Shuangliu District, No. 120 North City Street, Dongsheng Subdistrict, Shuangliu District, Chengdu 610200, Sichuan Province, China. liujianping2026@126.com
Received: April 8, 2026 Revised: May 6, 2026 Accepted: May 26, 2026 Published online: July 27, 2026 Processing time: 110 Days and 4.3 Hours
Abstract
Pancreaticoduodenectomy (PD) is a classic surgical procedure for treating benign and malignant lesions of the pancreatic head, duodenum, and periampullary region. Enhanced recovery after surgery (ERAS) has been widely applied to the perioperative management of PD by integrating a series of perioperative optimization measures. However, its pathways are difficult to adapt to individual differences among patients. In clinical practice, insufficient individual adaptation often leads to decreased ERAS compliance, poor rehabilitation outcomes, and even increased risk of complications. This article aims to systematically review the key variables in individualized PD-ERAS management, including core influencing factors at the patient, disease and surgical, and perioperative intervention levels. Based on this, individualized optimization strategies for each perioperative stage are proposed, providing evidence-based support and practical reference for optimizing perioperative management of PD, improving rehabilitation quality, and enhancing patient prognosis.
Core Tip: This review systematically examines key variables influencing individualized enhanced recovery after pancreaticoduodenectomy, encompassing patient-level factors, disease/surgical characteristics, and perioperative interventions. It proposes a stratified, dynamic optimization strategy for each surgical stage. This patient-tailored approach, prioritizing safety and precision, aims to enhance recovery after pancreaticoduodenectomy compliance, reduce mild complications, and improve postoperative outcomes, moving beyond standardized “one-size-fits-all” protocols.
